Healthcare Provider Details

I. General information

NPI: 1003875493
Provider Name (Legal Business Name): HEALTHYLIFE,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11613 W WASHINGTON BLVD
LOS ANGELES CA
90066-5915
US

IV. Provider business mailing address

11613 W WASHINGTON BLVD
LOS ANGELES CA
90066-5915
US

V. Phone/Fax

Practice location:
  • Phone: 213-637-9700
  • Fax: 213-637-9705
Mailing address:
  • Phone: 213-637-9700
  • Fax: 213-637-9705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number060000682
License Number StateCA

VIII. Authorized Official

Name: MRS. VARDUHI BABAYAN
Title or Position: CEO
Credential:
Phone: 213-637-9700